Epigenetic Changes in Endothelial Progenitors as a Possible Cellular Basis for Glycemic Memory in Diabetic Vascular Complications

This review summarizes past and recent research on the role of glycemic memory in the prognosis of diabetic micro and macro vascular complications, covering from experimental in vitro models to human clinical trials

Poojitha Rajasekar; Christina L. O’Neill; Lydia Eeles; Alan W. Stitt; Reinhold J. Medina

2015

Scholarcy highlights

  • The concept of glycemic memory refers to the inexorable progression of diabetic vascular complications which is linked to uncontrolled glycemia early in the disease despite a significant follow-on period of improved glycemic control
  • This investigation was designed following preliminary clinical studies reporting that diabetic retinopathy progression could not be arrested but worsened with tighter glycemic control and established that diabetic retinopathy could be prevented in diabetic dogs only if tight glycemic control began within 2 months of diabetes onset
  • The Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications human clinical trials have demonstrated that the level of glycemic control early in the disease process will dictate the speed of progression for diabetic retinopathy
  • A report on 8-year follow-up indicated that previous intensive treatment group still benefited from a delayed progression of diabetic nephropathy . 18-year follow-up on EDIC once more demonstrated a persistent benefit for the original intensive therapy group when compared to the conventional one on retinopathy progression
  • The consensus view is that an effective way to diminish diabetic vascular complications is early diagnosis and initiation of appropriate glycemic control measures
  • The worldwide prevalence of diabetes has been estimated to increase up to 55% by 2035
  • Considering their extended lifespan and vascular homeostatic function, it is likely that the glycemic memory affects endothelial progenitor cells and that this contributes to the impaired vasoreparative capacities of diabetic tissues

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